| Organization Name: | SOUTH METRO THERAPLAY, LLC |
| NPI Number: | 1851392997 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANDREA KAY MALECHA (PRESIDENT) |
| Mailing Address: | 314 Main St E Suite 3 New Prague |
| State: | MN US |
| Postal Code: | 560712448 |
| Phone Number: | 9527585775 |
| Fax Number: | 9527585778 |
| NPI Enumeration Date: | 08/10/2005 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | ========= |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MN |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |